NPIMap

Organization Active NPI

Dietz Regenerative Health Corporation

  • Anatomic Pathology & Clinical Pathology Physician
  • Ventura, CA
National Provider Identifier
1174402010
Registry record updated Dec 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
DIETZ REGENERATIVE HEALTH CORPORATION
Practice address
3717 Telegraph Rd
Ventura, CA 93003-3420
Phone
(805) 586-2068
Fax
(805) 504-1160
NPI assigned
Aug 27, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Robin Lloyd Dietz Jr., MDNPI 1306256292
Title
Owner
Phone
(805) 603-1549

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZP0102X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

3717 Telegraph Rd
Ventura, CA 93003-3420

Mailing address

3717 Telegraph Rd
Ventura, CA 93003-3420
Phone (805) 586-2068

Other names 2

  • Stoked Regenerative Health Doing business as
  • Ventura Wound Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250929001617 CA Part B Supplier - Clinic/Group Practice 0547766644 Receives reassigned benefits from 8 practitioners
Practice locations: Ventura, CA

National Provider Directory

National Provider Directory

Locations

1363 Donlon St
Ste 17
Ventura, CA 93003
Phone (805) 760-5005

3717 Telegraph Rd
Ventura, CA 93003
Phone (805) 586-2068

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1756252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766448000000",
    "number": "1174402010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3717 TELEGRAPH RD",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930033420",
            "telephone_number": "805-586-2068",
            "fax_number": "805-504-1160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3717 TELEGRAPH RD",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930033420",
            "telephone_number": "805-586-2068",
            "fax_number": "805-504-1160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIETZ REGENERATIVE HEALTH CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-27",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A",
        "authorized_official_last_name": "DIETZ",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "LLOYD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-603-1549",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stoked Regenerative Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ventura Wound Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ventura, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.